Schemm R L, Gitlin L N
Department of Occupational Therapy, Philadelphia College of Pharmacy and Science, Pennsylvania 19104-4495, USA.
Am J Occup Ther. 1998 Apr;52(4):276-82. doi: 10.5014/ajot.52.4.276.
This article describes the methods occupational therapists use to teach bathing and dressing device use to older patients in rehabilitation programs. The relationship of three patient characteristics to five aspects of assistive device instruction was examined.
The study sample included 86 patients and 19 occupational therapists who provided the assistive device training. Patients were 55 years of age or older and in rehabilitation for an orthopedic deficit, cerebrovascular accident, or lower limb amputation. Therapists recorded information on teaching methods, perceptions of patient knowledge, and expectations for future device use after each treatment session.
Patients received an average of three dressing and two bathing devices for home use. Therapists devoted an average of two and a half sessions (10 min average duration) to teach dressing device use and an average of one session (9 min average duration) to teach bathing device use. Teaching occurred mostly in the clinic setting through oral instruction and demonstration. At discharge, patients who evaluated devices positively and were evaluated as having a positive affect were perceived by the therapists as "having greater knowledge of device use." More time was spent teaching those patients with lower Functional Independence Measure scores, less positive evaluations of devices, and lower affect scores. Family caregivers were involved in one or more dressing sessions for 26% of patients and one or more bathing sessions for 36% of patients.
Assistive device training in rehabilitation centers consists largely of simulated sessions in the occupational therapy clinic, and patients in the study described the instruction they received as "satisfactory." More research is needed to study the long-term effectiveness of assistive device training after patients return home.
本文介绍了职业治疗师在康复项目中向老年患者教授使用沐浴和穿衣设备的方法。研究了患者的三个特征与辅助设备使用指导的五个方面之间的关系。
研究样本包括86名患者和19名提供辅助设备培训的职业治疗师。患者年龄在55岁及以上，因骨科缺陷、脑血管意外或下肢截肢而接受康复治疗。治疗师在每次治疗 session 后记录有关教学方法、对患者知识的看法以及对未来设备使用的期望的信息。
患者平均获得三种用于家庭使用的穿衣设备和两种沐浴设备。治疗师平均花费两个半小时（平均时长10分钟）教授穿衣设备的使用，平均花费一个 session（平均时长9分钟）教授沐浴设备的使用。教学主要通过口头指导和示范在诊所环境中进行。出院时，如果患者对设备评价积极且被评估为有积极影响，治疗师会认为他们“对设备使用有更多了解”。对于功能独立性测量得分较低、对设备评价不太积极且情感得分较低的患者，会花费更多时间进行教学。26%的患者有家庭护理人员参与了一次或多次穿衣环节，36%的患者有家庭护理人员参与了一次或多次沐浴环节。
康复中心的辅助设备培训主要包括在职业治疗诊所进行的模拟环节，研究中的患者将他们接受的指导描述为“令人满意”。需要更多研究来探讨患者回家后辅助设备培训的长期效果。
